Cardiac health in patients with hepatitis B virus-related cirrhosis

Abstract

Not only alcoholic cirrhosis related to cardiac dysfunction, cirrhosis caused by nonalcoholic etiology including hepatitis B virus (HBV) infection also related to impaired cardiac health. The aims of present study were to perform a noninvasive evaluation of cardiac function and to evaluate exercise performance in HBV related cirrhotic patients without typical symptoms of cardiac disease. Seventy-nine HBV related cirrhotic patients and 103 matched subjects without a previous history of cardiac involvement were recruited. Clinical examination and cardiac health evaluation were performed. The incidence, risk factors of cardiac dysfunction and exercise tolerance were investigated. A correlation between QTc interval and model for end-stage liver disease score ( R = 0.239, P = .018) was detected, however, the connection between QTc prolongation and the severity of liver disease was uncertain. Patients with HBV related cirrhosis had a tendency toward left ventricular wall thickening ( P = .007). Forty-one patients (51.90%) were in accordance with the definition of cirrhotic cardiomyopathy, and a significant increase in the incidence of cardiac diastolic dysfunction (CDD) could be found with increasing Child-Pugh grade ( P = .004). HBV related cirrhotic patients with CDD had a higher level of pro-brain natriuretic peptide ( P = .025), international normalized ratio ( P = .010) Child-Pugh score ( P = .020), and a higher proportion of ascites ( P < .001). The higher Child-Pugh score (odds ratio = 1.662, P = .010) was an independent diagnostic predictor of CDD. The cardiac depression and exercise tolerance also got worse with increasing Child-Pugh score ( P < .001). Impaired cardiac health was common in HBV related cirrhotic patients. Cardiogenic factors must be carefully considered in the integral therapy of cirrhosis. Hepatology physicians should lay emphasis on exercise training in daily life.

Comparative evaluation of cardiac health in patients with chronic liver disease secondary to HCV, HBV, and NASH

“…Our findings showed increased levels of triglycerides in association with NASH compared to the other two groups. As dyslipidemia is another feature of the metabolic syndrome, which is the main criminal of NASH pathogenesis, it is reasonable to detect high triglyceride levels in such patients [40]. Our study has some limitations; first of all, we included a relatively small sample size.…”

Prevalence and risk factors for cirrhotic cardiomyopathy: a prospective cross-sectional study

“…A study by Yuan et al . [19] also reported a higher incidence of ascites in patients with cirrhosis combined with cardiac diastolic dysfunction. In addition, studies have found that patients with ascites have more severe LVDD than those without ascites [7].…”

Advances in cirrhotic cardiomyopathy

“…These data demonstrated that exercise training mitigates the CCM phenotype [33 ▪ ]. Yuan et al demonstrated that physical exercise improves the functional status and survival rate in patients [34]. Clinicians should emphasize the beneficial effect of exercise to improve the quality of life in patients with CCM.…”